Authors (including presenting author) :
Chau RMW, Woo CW, Chan JSP, Leung KKL, Tsui AYY, Tang RSK, Cheung EYY, Chan BKS, Chan DYC, Lee SKF, Lau MHL, Wong EYW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Fall remains as commonly identified risk in cluster, hospital & department risk register & constituted prevalent reported patient incidents(PTCOC incident statistics). Bearing multi-factorial causes, multi-facets fall management is warranted and sustainability hinges on safe culture & concerted effort from all. Safety Optimization Program(SOP) has been implemented in the Physiotherapy Department of KCC since 2003 upon clustering. Hospital based care process initiatives encompassed collaborative work with wards for timely patient’s mobility status update & signaling in Kowloon Hospital while department based work included fall prevention & management algorithm with stratified care pathways compatible to patient’s conditions. Structure of care included Environment Ambassadors Program with designated staff taking charge of the equipment, environmental setting & auxiliary support, user re-designed handling belt for transfer and ambulatory training project(2016) & full review of portering services(2018) to support the high volume intra-hospital portering(>900 daily portering). An on-going CQI project is implemented to assure system-in-place in fighting patient’s fall with sustainable safe culture.
Objectives :
To audit multi-facets fall management for uphold of patient safety against fall and review sustainability & areas for enhancement
Methodology :
Data were extracted from content audit of physiotherapy records for stratified care of fall prevention & management algorithm and full investigation & analysis of all Fall incidents and auxiliary support from review of portering wheelchair workflow, maintenance check of wheelchair & walking aids & supporting staff proficiency. Regular environmental check was conducted by senior physiotherapists surprise walk-around.
Result & Outcome :
The physiotherapy record content audit showed appropriate care given to patients in compliance to the fall prevention & management algorithm. Zero patient fall incident was maintained since 2015. Full compliance to portering, MHO, maintenance check of wheelchair & walking aids was found. Timely detection of wheelchair/walking aids defects in maintenance check provided better patient safety protection and service productivity. The high compliance might be contributed by the high staff engagement & ownership with previous early great involvement of stakeholders in the concerned CQI projects. Peer-group mentoring from experienced supporting staff together with structured on-the-job training facilitated practical knowledge and skills transfer to newly recruited supporting staff for sustainability of safe culture. No comment/suggestion was received on portering and treatment venue stationed duty from supporting staff who was empowered to deliver auxiliary support with clear role-specific work instructions and staff training to ensure service quality. Minor enhancement for equipment & furniture re-arrangement was identified from environmental check. In summary, there is system-in-place with the multi-facets fall management for uphold of patient safety as supported by the sustainable zero fall incident.
